303776
Patterns of Emergency Department Use By Torture Survivors at the Libertas Center for Human Rights
Methods: The study utilized data from a retrospective chart review of primary torture survivors over age 18 who sought care at Libertas and the Elmhurst Hospital ED between 2007-2013. Demographic information, torture history, and acuity and disposition of ED visits before and after intake at Libertas were extracted. Each ED visit diagnosis was coded according to the ICD9-CM and further classified as (1) non-emergent, emergent/primary care treatable, or emergent but preventable, and (2) emergent and not preventable.
Results: Study subjects were predominantly male (67%), aged 25-55 years (60%), and most commonly from Columbia (21%). Torture types most frequently recorded were threats/psychological (88%), beating (74%), and rape/sexual violence (33%). Subjects had 90 total visits to the Elmhurst ED, of which 47 occurred before subjects’ Libertas intake and 43 after. 45% of ED visits before intake were acute/ critical versus 65% after intake. Hospital admissions increased from 9% before intake to 16% after. After classification, 19% of ED visits before intake were likely truly emergent compared to 28% of visits after. In contrast, the number of visits dispositioned as against medical advice or left without being seen decreased from 19% before intake to 0.05% after.
Conclusions: The Libertas Center may increase clients’ knowledge about appropriate use of medical resources and increase access to non-emergent medical care.
Learning Areas:
Public health or related researchLearning Objectives:
Describe patterns of Emergency Department (ED) use by torture survivors at the Libertas Center for Human Rights. Evaluate the hypothesis that torture survivors who are clients of the Libertas Center will utilize ED services and resources more appropriately after accessing care through Libertas than before.
Keyword(s): Human Rights, Health Care Access
Qualified on the content I am responsible for because: I am a second year medical student at the Icahn School of Medicine at Mount Sinai and a 2013 University of California Human Rights Fellow. I completed my masters in Global Health Sciences at UCSF prior to medical school where I gained training and experience in public-health based research. This abstract submission is based on the results of my work as a student intern at the Libertas Center for Human Rights this past summer.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.